Li Ka Shing Knowledge Institute, Applied Education Research Operatives (AERO), Faculty of Medicine, University of Toronto at St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON, M5B1W8, Canada.
University of Toronto, Rehabilitation Sciences Institute, Toronto, ON, Canada.
Adv Health Sci Educ Theory Pract. 2024 May;29(2):487-505. doi: 10.1007/s10459-023-10255-6. Epub 2023 Jul 16.
While patient engagement in healthcare professions education (HPE) has significantly increased in the past decades, a theoretical gap remains. What are the varied reasons as to why patients get involved with HPE programs? With a focus on understanding what drives patient involvement with HPE programs, this study examined how a patient as teacher (PAT) program was experienced by medical students, patient teachers, and faculty within a medical school. Through a phenomenographic approach, this study captures and describes the different ways our study participants experienced a PAT program (the 'phenomenon'). 24 semi-structured interviews were conducted in total, comprised of interviews with patient teachers (N = 10), medical students (N = 10) and program facilitators (N = 4) who participated in a PAT program. Our focus was on participants' description of the program and was grounded in their experiences of as well as their beliefs about it. Our findings captured 4 layers representing the qualitatively different (yet interrelated) ways in which participants experienced/perceived and conceptualized the various aspects of their experience with the PAT program: (1) A productive disruption of the learning space (2) A re-humanization within healthcare (3) A means of empowerment and agency (4) A catalyst for change and emancipation. Our outcome space results can be visually illustrated by a nesting "Matryoshka" doll, representing the four layers and depicting the process of uncovering the less conscious layers of sense-making within this phenomenon. HPE programs that are co-produced with patients and actively involve patients as teachers have the potential, but not guarantee, to be emancipatory. To engage in PAT programs that exhibit an emancipatory potential, we need to consider transformative paradigms of education, which are aligned with social change, and disrupt the traditional teacher-learner hierarchy.
尽管患者在医疗保健专业教育（HPE）中的参与度在过去几十年中显著提高，但理论上仍存在差距。患者参与 HPE 计划的原因有哪些？本研究关注的是理解为什么患者会参与 HPE 计划，以及为什么患者会参与 HPE 计划，研究了作为教师的患者（PAT）计划在医学院中是如何被医学生、患者教师和教师所体验的。通过现象学方法，本研究捕捉和描述了我们的研究参与者体验 PAT 计划的不同方式（“现象”）。总共进行了 24 次半结构化访谈，包括参与 PAT 计划的患者教师（N=10）、医学生（N=10）和项目协调员（N=4）的访谈。我们的重点是参与者对该计划的描述，并基于他们对该计划的体验和信念。我们的研究结果捕捉到了 4 个层次，代表了参与者体验和感知以及概念化他们在 PAT 计划中各种方面的方式存在不同但相互关联的差异：（1）学习空间的富有成效的干扰（2）医疗保健中的再人性化（3）赋权和代理的手段（4）变革和解放的催化剂。我们的结果空间结果可以通过嵌套的“Matryoshka”娃娃来直观地说明，代表了四个层次，并描绘了揭示这一现象中意识形成较少层次的过程。与患者共同制定并积极让患者作为教师参与的 HPE 计划具有解放潜力，但不能保证。要参与具有解放潜力的 PAT 计划，我们需要考虑与社会变革相一致的教育变革范式，并打破传统的师生等级制度。
